Brow Lift/Forehead Lift

A Brow Lift or Forehead Lift is a facial cosmetic procedure that helps to elevate the brows, forehead and area between the brows from lack of elasticity due to aging, gravity, trauma and facial hyperactivity in order to bring back a more youthful look. Among the common factors for seeking a Brow Lift are that the patients’ current appearance makes them look angry, tired and older than they really are. Brow Lift surgery can help alleviate these problems, leaving you in a better state of mind, both physically (appearance) and psychologically (confidence). The procedure can be done alone or combined with other types of facial cosmetic surgeries, such as Blepharoplasty (Eyelid surgery) and Facelifts.

Candidates of Brow Lift surgery typically have one or more of the following forehead area problems:

• Having transverse folding lines across the forehead (above the eyebrows) - It is a common contributor of appearing older.
• The vertical line between the eyebrows (glabellar lines) - These lines located between your brows can easily make you look angry or upset.
• Drooping brows (a problem above the brow lines) can create confusion with the falling or excessive tissue of the upper eyelids. In these case types, the surgeon will examine the skin texture, elasticity and the possibility of performing both brow lift and eyelid surgeries at the same time.

During the pre-operation consultation, the surgeon will evaluate the potential patient’s individual needs and possibilities based on the patient’s realistic goals. The surgeon will review any intensive medications taken previously, medical history, previous surgery, cosmetics used, and current facial structure and give the patient a skin evaluation. Patients need to communicate clearly with the surgeon what is bothering them and what their realistic goals are. The surgeon will support these ideas with his/her professional opinion and might make recommendations for a better result depending on the individual case.

There are many techniques used for a brow lift surgery depending on an individual’s conditions. Coronal incision technique is one of the most common traditional brow lifts that result in a more invasive way and slower recovery period, since the surgeon has made a headphone shaped incision across the patient’s head (a head band sitting position). Top New York Facial Plastic Surgeon Dr. Sam Rizk has an Endoscopic approach to minimize the invasive surgery. With his Endoscopic technique, 3-5 small incisions are made through the hairline or behind the hairline in order to hide the scars, then the 3D high definition endoscope is inserted for a clearer view that allows the surgeon to work with more precision. Dr. Rizk also favors the use of an Endotine ribbon and tissue glues to assure the brows position for a rapid recovery and longevity.

Like every kind of surgery, there is always the possibility of incurring risks and complications. While there are only rare occasions of complications associated with brow lift surgery, here are a few examples:

• Nerves that are responsible for the eyebrows’ motions might get injured either on one side or both.
• Visible scars that can be improved over time or with the revision surgery.
• Loss of sensation around the incision areas. There is a higher chance of this risk especially with patients who had a traditional coronal brow lift.
• Hair loss around the scar sites.

There are many ways to fix the deep tissue of the brow to the newer higher position, some dissolvable over time and some non-dissolvable. Expert New York City Facial Plastic Surgeon Dr. Rizk prefers the endotine fixation, which is the least invasive and dissolves like a stitch over months. Dr Rizk feels it is necessary to have at least 3 months of fixation to achieve permanence in the newer higher position of the brow. The endotine fixation system dissolves over a 4 month period. Dr. Rizk does not feel it is necessary or good for the body to have a permanent, nondissolvable material to use for fixation of the deeper brow tissue.

Also, Dr. Rizk does not advocate the older coronal brow technique because of the large scar and concomitant increased potential for hair loss and numbness, especially with availability of high definition telescope systems. These telescope systems are the surgeon's eyes to visualize the brow from smaller less invasive incisions.

Lastly, Dr. Rizk also advocates the lesser invasive partial lateral (temporal) brow lift done to address the brow hooding on the corner of eyebrows which makes a person appear sad or tired. This technique is indicated in younger patients with only lateral eyebrow hooding, without significant aging changes in the brow. It is done through only 2 small incisions inside the temporal hair. It can also be combined with an upper eyelift or facelift. Dr. Rizk does not use drains and uses instead tissue glue to expedite the healing process and decrease recovery time, which is about 5 days, using Dr. Rizk's techniques to look socially presentable. Eliminating the drain has dramatically decreased scarring and expedited recovery as well as decreased the risk of infection.